Peking Union Medical College (PUMC) and the Chinese Academy of Medical Sciences (CAMS) share a history of firsts. PUMC was the first medical university in China authorized to grant M.D. degrees to students who have finished an eight-year curriculum that starts in undergraduate school. CAMS, its sister institution, is a leading multidisciplinary medical research institution that, among its many accomplishments, developed the new antitumor drug icotinib. CAMS and PUMC run 19 institutes, 7 satellite centers, 6 hospitals, and 7 schools. The pair are now seeking another series of firsts—to make PUMC an international research-based medical university and to transform CAMS into the “Chinese National Institutes of Health,” giving it international standing. Despite the many dramatic changes in China since their founding, PUMC and CAMS have remained true to their mission and heritage as elite medical and research institutions. No doubt many more firsts remain in their collective future.